Clinical rounds serve several key objectives in academic medical centers: providing a forum for patient communication, clinical decision making, and teaching. Nonclinical colleagues ordinarily do not have the opportunity to round, and the idea of implementing a rounding program that includes nonclinical colleagues has received little attention to date. Reasoning that a rounding program with nonclinicians could enhance (1) understanding of the organization's clinical mission, (2) appreciation of caregivers' roles, and (3) engagement, the authors created such a program. From 2010 to 2013, 51 nonclinicians within the Cleveland Clinic Education Institute participated; 14 submitted written reflections, and 27 responded to a survey about their experience. Overall, 12 themes emerged that suggest an enhanced familiarity with the institution and increased engagement and alignment with its mission. Notably, the results align with a long-standing focus on organizational engagement and an observed increase in mean engagement scores since the program was implemented.
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http://dx.doi.org/10.1177/1062860614521657 | DOI Listing |
Contraception
January 2025
Divisions of Clinical Research and Complex Family Planning, Contraception, and Gynecology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, United States; Division of Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States.
Objective: To explore differences in demographic characteristics and telehealth usability between patients who chose video versus telephone for telehealth contraceptive counseling.
Study Design: This was a secondary analysis of a prospective cohort comparing the interpersonal quality of contraceptive counseling between in-person and telehealth visits at a single Title X-funded clinic. Before the clinical visit, a non-clinician counselor provided structured contraceptive counseling based on patients' preferred modality.
Crit Care Explor
June 2023
Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Unlabelled: Initial Society of Critical Care Medicine Discovery Viral Infection and Respiratory illness Universal Study (VIRUS) Registry analysis suggested that improvements in critical care processes offered the greatest modifiable opportunity to improve critically ill COVID-19 patient outcomes.
Objectives: The Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 ICU Collaborative was created to identify and speed implementation of best evidence based COVID-19 practices.
Design Setting And Participants: This 6-month project included volunteer interprofessional teams from VIRUS Registry sites, who received online training on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury approach, a structured and systematic method for delivering evidence based critical care.
Introduction: Shared decision making (SDM) may result in treatment plans that best reflect the goals and wishes of patients, increasing patient satisfaction with the decision-making process. There is a knowledge gap to support the use of decision aids in SDM for anticoagulation therapy in patients with atrial fibrillation (AF). We describe the development and testing of a new decision aid, including a multicenter, randomized, controlled, 2-arm, open-label ENHANCE-AF clinical trial (Engaging Patients to Help Achieve Increased Patient Choice and Engagement for AF Stroke Prevention) to evaluate its effectiveness in 1,200 participants.
View Article and Find Full Text PDFHEC Forum
March 2020
Department of Neurology, Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
In the United States, there is no consensus about who should make decisions in acute but non-emergent situations for incapacitated patients who lack surrogates. For more than a decade, our academic medical center has utilized community volunteers from the hospital ethics committee to engage in shared decision-making with the medical providers for these patients. In order to add a different point of view and minimize conflict of interest, the volunteers are non-clinicians who are not employed by the hospital.
View Article and Find Full Text PDFJ Pediatr Nurs
September 2018
Nursing Research and Innovation, Cleveland Clinic Health System, Cleveland, OH, United States.
Purpose: Determine if the pediatric peripheral vascular access algorithm (PPVAA) led to differences in first-attempt and overall peripheral intravenous (PIV) success, staff attempting PIV access per episode and overall attempts and first PIV attempt success by provider.
Design/methods: A two-cohort pre-/post-implementation comparative design involved pediatric nurses and patients. The PPVAA included four components: a patient comfort plan, PIV grading score, nurses' self-assessed IV access capability and nurse decision to stop-the-line.
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